Developmental writing disorders: assess to rehabilitate.

BACKGROUND: Writing ability requires to use and control several processes of visual and phonological information processing and an adequate programming and coordination of motor sequences. We studied a writing precursor gesture in children with developmental dysorthography and/or developmental dysgraphia in order to point out anomalies to be treated with specific rehabilitative interventions. METHODS: Twenty-five children affected by developmental dysortography (ICD 9 CM: 315.09; ICD 10: F81.1) and/or developmental dysgraphia (ICD 9 CM: 315.2; ICD 10: F81.8) (mean age 9.1 years [range: 6.3-11.4 years]) ran a maze, project in front of them, using a wireless mouse. Data regarding angular excursions, execution times and gesture accuracy were collected and elaborated using Dartfish 6.0 software and the labyrinth generating program (PRINC), and compared with normative data previously obtained from a sample of 226 healthy children of the same age and grade. RESULTS: The comparison did not evidence significant differences regarding gesture structure (trajectories of arm segments and angular excursions of interested joints). Angular and temporal execution patterns were reached in delay in these children. No correlation was found with general cognitive and visuomotor integration skills; a deficit of visual attention was associated with an abnormal elbow range of motion. CONCLUSIONS: Although these findings need to be confirmed in larger studies, data obtained evidence that children with developmental writing disorders have a time delay in the acquisition of writing motor patterns and not an alteration of gesture structure itself. This has relevant implications for the rehabilitative approach.

Specific learning disorders and anxiety: a matter of school experience?

BACKGROUND: Specific learning disorders (SLDs) are a group of neuropsychological disorders which reduce a child's ability to read and/or write and/or use numbers. Internalizing disorders, and in particular anxiety, has been reported as a relatively common comorbidity in children with reading difficulties. We conducted this study in order to test if school experience (in terms of perceived support from the teacher) is associated with the development of anxiety. METHODS: Twenty patients with SLDs (age: 8-13) were compared to 32 healthy subjects of the same age. All subjects filled the scale to measure anxiety derived from the Self-Administered Psychiatric Scales for Children and Adolescents (SAFA); results were compared using non-parametric statistics after verifying that scores were not normally distributed. RESULTS: Patients more often had a clinically significant level of anxiety (Mann Whitney U Test; P<0.001). We found a significant inverse correlation between a school experience perceived as positive and anxiety (Spearman's rho=- 0.925; P<0.001), while no significant correlation was found for sex, age, timeliness of diagnosis or time since diagnosis. CONCLUSION: Although these findings need to be confirmed in prospective studies, the role of school experience for children with SLDs seems highly relevant also for their psychological well-being.

Scientifically based nurture and nature: alternative but non exclusive hypotheses on attention development.

Attention is an important neuropsychological function in child development. A lot of literature has been devoted to trying to separate the role of nature (i.e. mainly the genetic basis) from that of nurture (i.e. parenting and life events). The case of preterm born children is an opportunity to try and further study this relationship. We hypothesize that children born preterm might have a reduced attention due to an interaction of factors, to be conceptualized both as nature (mainly the genetic background and the specific consequences of preterm birth and of its complications) and nurture (therapeutic techniques used, alteration in parents-child relationship and so on). The contribution of each of these factors needs to be disembodied from the raw finding of a reduced attention: this is especially important because experience-dependent learning, in which individualized experiences have neural effects, can go on throughout life and this opens interesting rehabilitative possibilities. Different research lines which could be useful to entangle the specific contributions of the above mentioned factors are discussed: the results could in turn inform clinical practice with this highly at risk and increasing in number population, with a view largely corresponding to the one founding the OMS International Classification of Disability, Functioning and Health.